Obliteration of the persistently discharging mastoid cavity using the middle temporal artery flap

Abstract

To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma. A five-year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperiosteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low-maintenance cavity as assessed by a semi-quantitative scale. A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow-up of 12 months; 43 (84%) had a small dry healthy mastoid cavity; three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy. Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre-existing cavities and also those not previously operated upon.